年轻复发性流产患者PGT-A临床应用 价值分析
Clinical Utility of PGT-A in Young Patients with Recurrent Pregnancy Loss
摘要: 复发性流产(RSA)是育龄期女性的常见生殖健康问题，胚胎染色体非整倍体是其主要病因。胚胎植入前非整倍体遗传学检测(PGT-A)在高龄RSA患者中应用价值明确，但在年轻RSA患者中仍存争议。本文系统梳理年轻患者胚胎非整倍体的形成机制与危险因素，汇总PGT-A在年轻RSA患者中的临床证据，并从获益与风险两方面进行临床考量。现有研究表明，PGT-A的获益遵循分层原则：对于既往流产组织证实为非整倍体、夫妻核型正常、卵巢储备功能正常的年轻RSA患者，PGT-A可提高临床妊娠率及活产率；而对于无明确不良孕产史、卵巢储备减退者，获益证据不足。临床决策应在多维度病因评估基础上，遵循个体化原则，实现从经验化向精细化转型。
Abstract: Recurrent spontaneous abortion (RSA) is a common reproductive health issue among women of childbearing age, with embryonic chromosomal aneuploidy being its primary etiology. Preimplantation genetic testing for aneuploidy (PGT-A) has demonstrated clear clinical value in older RSA patients, but its application in young RSA patients remains controversial. This review systematically summarizes the mechanisms and risk factors of embryonic aneuploidy in young patients, consolidates the clinical evidence of PGT-A in young RSA patients, and evaluates its benefits and risks from a clinical perspective. Current evidence indicates that the benefits of PGT-A follow a stratified principle: for young RSA patients with prior miscarriage tissue confirmed as aneuploid, normal parental karyotypes, and normal ovarian reserve, PGT-A can improve clinical pregnancy and live birth rates; however, for patients without a clear history of adverse pregnancy outcomes or with diminished ovarian reserve, evidence of benefit is insufficient. Clinical decision-making should be based on a multidimensional etiological evaluation, adhering to the principle of individualization, thereby achieving a shift from experience-based to precision-based management.
文章引用：谢慧娟, 李维宏. 年轻复发性流产患者PGT-A临床应用 价值分析[J]. 临床医学进展, 2026, 16(4): 3948-3959. https://doi.org/10.12677/acm.2026.1641663

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